The Health and Wellbeing Board is scheduled to discuss a range of important topics, including an update on the integrated health and wellbeing performance and service delivery, a review of the draft Joint Health and Wellbeing Strategy, and the Better Care Fund plan for 2026/27. The meeting will also cover an update on the Occupational Therapy service and future agenda items.

Integrated Health and Wellbeing Performance Report and Service Update

The Board is scheduled to receive an update on progress against Hillingdon's strategic priorities and the transformation programmes supporting them. These priorities include Best Start in Life, Live Well, Age Well, Healthy Places, and Equity & Inclusion, which align with the West and North London Integrated Care Board's (W&NL ICB) Core20PLUS5 priorities. The report is expected to highlight areas of stabilisation and measurable improvement, particularly in discharge performance, frailty management, and mental health crisis flow. It will also detail progress in Integrated Neighbourhood Teams (INTs), reactive care, and the Best Start in Life programme for children and young people. The report will also cover the Better Care Fund (BCF) end-of-year review.

Key improvements noted in the report include a reduction in No Criteria to Reside (NC2R) patients, progress in frailty case management, and improved mental health crisis response through the Lighthouse model. The report will also detail the uptake of mobile diagnostics, which has shown evidence of avoiding hospital conveyances and generating system savings. However, areas where performance remains off-track include Emergency Department (ED) attendances and bed days, with length of stay being a significant concern. The report will also address the Hypertension target, which is currently off track.

Priorities for the next quarter (to September 2026) include sustaining NC2R levels, translating frailty improvements into bed-day reductions, and fully mobilising the Reactive Care model. The Hospital to Community Transformation (left shift) programme, aimed at reducing outpatient appointments and providing community support for patients who would otherwise require acute care, will also be a focus. The Board is asked to provide continued oversight and support for the scaling of the place operating model.

Joint Health and Wellbeing Strategy 2026-2031: Update

The Board is scheduled to receive an update on the outcomes of the public consultation for Hillingdon's Joint Health and Wellbeing Strategy 2026-2031. The strategy, developed by Hillingdon Health and Care Partners, sets out a shared vision for a fairer, healthier, and more integrated Hillingdon, structured around four life-course outcomes: Best Start in Life, Live Well, Age Well, and Healthy Places. It identifies seven high-impact programmes, including neighbourhood proactive care, hypertension detection, mental health early intervention, frailty and falls, and reducing No Criteria to Reside.

The consultation involved residents and health and social care professionals. Residents identified Faster help when something goes wrong, Better joined-up care, and Prevention and early help as top priorities. Key difficulties residents experienced included accessing urgent and emergency services, managing the cost of living, and dealing with long-term conditions and mental health issues. Common themes from resident feedback highlighted concerns about GP access, hospital outpatient waiting times, urgent care access, and mental health services. Professionals generally supported the strategy's priorities but expressed some uncertainty about the realism of its ambitions and delivery plan.

The report proposes amendments to the strategy, including changing the Best Start in Life heading for children and young people to Start Well to align with the World Health Organisation's life-course model. It also proposes adding a target to attain 'UNICEF UK Baby Friendly' accreditation status across relevant settings and refining the breastfeeding KPI. The Board is asked to note the consultation outcomes, approve the proposed amendments, and delegate authority to the Corporate Director of Adult Social Care and Health to approve the final strategy and delivery plan.

2026/27 Better Care Fund Update

The Board is scheduled to consider the 2026/27 Better Care Fund (BCF) plan, which aims to support national policy objectives of shifting from sickness to prevention and enabling people to live independently. The plan outlines how funding will be used to deliver integrated and preventative care, linked to neighbourhood health and social care services. It also details compliance with expenditure and grant conditions, and governance, reporting, and engagement requirements.

The plan includes four schemes: Living Well (aimed at maximising independence and preventing unnecessary admissions for adults of working age), Age Well (for people aged 65+), Active Recovery (promoting recovery and independence after acute illness), and Infrastructure Enablers (providing foundations for operational service delivery). Key priorities for 2026/27 include further developing Integrated Neighbourhood Teams (INTs), implementing the Hospital to Community Transformation ('left shift') to focus on prevention, and implementing a single borough-wide Reactive Care Service.

Changes from the 2025/26 plan include adjustments to service funding streams, the introduction of a Senior Clinical Decision Maker role, and additional contributions to community mobile diagnostics. The plan also addresses the out-of-borough coordinator role and extends a pilot for self-funder advice and guidance. The report details compliance with national conditions and sets achievable targets for national metrics related to emergency admissions, discharge delays, and permanent admissions to care homes. The Board is asked to approve the 2026/27 BCF Plan and delegate authority for amendments arising from the national plan assurance process.

Occupational Therapy Service Update

The Board is scheduled to receive an update on the delivery of Occupational Therapy (OT) statutory contacts for children with Special Educational Needs and Disabilities (SEND), as outlined in their Education, Health, and Care Plans (EHCPs). The report highlights a national shortage of OTs, which has impacted service delivery and led to approximately 400 children not receiving their full entitlement of OT contacts during the 2024/25 academic year.

Central and North West London NHS Foundation Trust (CNWL), jointly commissioned to deliver these services, has implemented a recovery plan. This includes recruiting additional OT support from external organisations and ensuring all posts are fully covered. Plans are in place to ensure all children receive their statutory contacts, with the expectation that appropriate OT provision will have been delivered by the end of March 2026 for those impacted in the 2024/25 academic year. The report will also cover ongoing work to refine pathways, quantify workload, and identify efficiencies. The Board is asked to note the content of the report.

Board Planner & Future Agenda Items

The Board is scheduled to consider and provide input on the draft Board Planner for 2026/2027. This document outlines the schedule of future reports and standing items for Board meetings. The planner is flexible and can be updated as needed. The Board will also consider any items of current or emerging business that the Chair considers to be urgent.

The following items are scheduled for inclusion in future Board meetings: the results of the consultation on the Joint Health and Wellbeing Strategy 2026-2031, an update on the 2026/27 Better Care Fund Plan, and an update on the occupational therapy service.